I'm a California girl, born and raised here, with an abiding interest in health issues and particularly, healthy aging. I have always loved working with older people, probably because I had this amazing grandmother. She taught me so much about life, balance, how to be your own person, and how to savor the moment. She was a nurse and inspired me to be one, too. I evolved into a second career, practicing law, representing individuals. Now, I'm in the advice and conflict resolution field, focused on issues about aging and aging parents. This blog is dedicated to you, the one with the aging parent or aging loved one. Maybe it's just about all of us middle aged folks getting older ourselves. My husband, Dr. Mikol Davis, a psychologist, and I put our efforts together at AgingParents.com. We've got 2, 20-something kids and an 89 year old mother in law. Helping Mom is a big part of our lives. Lots of our friends are going through the same things we are: parents starting to decline in health or alertness, putting time in with all we can do to help out. The stresses affect you, and they affect me, too. I like to discuss these challenges and what you can do to meet them. Feel free to comment!

A Startling Reality: Your Aging Parent Runs Out of Money

Mom can go to a small care home, like assisted living but on a very modest scale. She would have to share a room to be able to afford the cost. And Marsha would have to pay the difference between mom’s income and the cost of the home.

Mom could eventually go to a nursing home, a thought which terrifies Marsha’s mom and depresses Marsha. Ironically, in most states, Medicaid will pay for a nursing home, but won’t pay for a caregiver at home to keep an aging parent out of a nursing home. The nursing home is obviously much more expensive than staying in one’s own home. Ridiculous? Of course! Tell your legislators. They can’t seem to agree on much of anything. What are the chances of getting a government funded program to pay for in-home care for seniors to keep them out of nursing homes?

I am working with Marsha to help her through the decision-making process. Her mom is included in the discussion. Mom is clear on one thing: she doesn’t want to move. Marsha just wants to preserve mom’s dignity.

What Marsha is learning is that what we want for our aging parents may be compromised by the economic reality of longevity. Lots of Boomers are supporting their aging parents, in whole or in part.

The takeaway here is this. We may not be able to do much advance planning for aging parents who live into their 90′s and beyond, but we can plan ahead for ourselves.

We see what happens to our parents. We need to work with our own trusted financial advisors and find our own long term strategies. Very long term.

Question of the day: if you live to be 100 (and you just might), could you make your money last that long? Could you pay for all of your own expenses, accounting for inflation, the cost of caregiving, and ups and downs of the market?

Sit down with your financial planner and do some calculations. Be smart. Be realistic. Planning ahead can make all the difference. Few of our parents anticipated such longevity, but we boomers must consider it to be quite possible. If we’re a rather rebellious generation, let’s rebel against financial dependency for our futures.

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A reverse mortgage would be fine if the home mom has were worth something. She’s in an area where prices have fallen precipitously. It’s worth less than $70K. A reverse mortgage would solve nothing, unfortunately. There are quite a few folks in that situation.

The financial aspect of this is bad enough, but what I really found tough was having to switch roles and be the parent to my mom and dad (my sister had founds the getting good and had moved away just before the health and financial problems began to set in). At that I would say the other half of preparing oneself for the end days is to ensure that there is someone there to help care for you, or at least check in on you once in a while. Stay on good terms with your friends, and most importantly your relatives and make sure your financial and personal houses are in order so that if the worst were to happen suddenly at least one person has access to all the accounts, policies and so on.

Jim: Thank you for your comment. You raise a very good point. Most of us just don’t connect with the reality that we may need help during the last part of our lives. Chances are, we will, especially as people just keep living longer and longer these days. Yes, appoint someone to be your durable power of attorney. Give the person your account numbers, passwords, and communicate your wishes about how you want to be taken care of when the time comes. You may not have all your marbles by then. I thank you for sharing the experience you had and I hope others can see it from your helpful viewpoint. It’s also good to have a backup person on the paperwork (durable power of attorney and healthcare directive), as the person you appoint may not live as long as you do.

Would it really hurt the daughter to take mom in for the few years she has remaining? The money that comes in for pension and Social Security would more than pay for any care that she doesn’t feel able to provide. It would be a good financial decision if the aging parent lived with a younger relative and didn’t use up all of their savings.

Thanks for your comment. No, it wouldn’t hurt the daughter to take mom in. It would be two of them in a one bedroom condo where the daughter lives. Mom would be alone all day with Marsha working. I’m not sure if you’ve checked into the cost of caregiving lately. Let’s get real about the cost.

To provide a caregiver at home for the mom 4 hours a day costs $25/hour (and up!) where the daughter lives. $100 a day is the real, out of pocket cost of a caregiver from a reputable agency to come in for the bath and safety. Mom’s income is $700 a month from Social Security and $100 a month from her pension. That’s enough to pay for eight half days of care a month, less than she needs. That doesn’t “more than pay for” the helper mom needs. Mom’s income, if used for caregiving, does not pay for supplemental health insurance premiums, medication Medicare doesn’t cover, food, clothing, etc. There are no other relatives who can or will pitch in. The money from the sale of mom’s home will last about a year. Then what? Marsha is not unique. I hear of these crises quite often.

You are so correct. I am appalled to think of a 97 year old lady with a daughter living alone. That the daughter expects taxpayers to ante up is ridiculous. That would be appropriate if there were no children, or if the children are ill, but “don’t get along” is not an excuse for not doing what’s right. I left my job and home at 62, accepting a greatly reduced pension, to go take care of my mother. It’s not always fun, and money is tight, but families come first.

Candace: You sound like the best kind of daughter! Not everyone is as selfless as you are in giving up a lot to care for an aging parent. And then, some aging parents were not good parents and are alienated or estranged totally from their adult children. We are in a difficult place in society now, with millions of parents living a lot longer than anyone thought they would. I hope more adult children see the wisdom and opportunity for good that comes from providing care to an aging parent, as you are doing. Bless you for it and may it go well.

I disagree with the idea that the daughter should take care of the mother herself rather than asking the taxpayer to “ante up.” The daughter is working full time to support herself and presumably provide for her own retirement. Her first responsibility is to herself and her own future. I don’t think it’s unreasonable to use public services or funds for her mother if there are any available. As a taxpayer, that’s why I pay taxes – to spread out the risk so that people caught in these unfortunate situations don’t have to bear the burden all alone. If you were able to stop work and care for your mother, and you chose to take a reduced pension, I hope that works for you. Everyone’s situation is different though – you can’t expect your solution to work for everyone else.

Carla, perhaps you missed the point. There is no suggestion that anyone MUST take care of an aging parent. I did not propose stopping work as the only solution; rather, it is a consideration lots of people do look at when an impoverished elder is in need of care. “Public funds” as you describe them do pay for a long term stay in a nursing home. They also pay, in many states, for limited in home support at low wages for the caregiver, who can be a family member. If the aging loved one needs full time care, in home services which are publicly funded do not pay for that amount of service. So the unpleasant choice is to put an aging parent in a nursing home to live on “publicly funded” care as you describe it or to provide some care yourself. It is not easy for most loving adult children to put an elder in a Medicaid funded bed in a low end nursing home. They can be very dangerous places. There are a few experimental assisted living programs which the Federal government also subsidizes, but in my state, these are the lowest end kinds of places that exist. If you ever had to make the choice yourself about where to care for a person who needed help and had run out of money, you would see how hard it is to make the decision. There are no easy answers to the issue. The notion that tax payer funded places are going to do a good or even adequate job of the care is a fantasy. I know this from personal experience of being an aide and an RN in a nursing home. Thank you for your comment.

Carol, I was responding to Candace’s comment, not yours (or the blog post). I’m sorry it wasn’t clear. The comment in question seemed to express condemnation against the use of public funds and against any adult child who did not provide the parent’s care him/herself. Her exact words were “That the daughter expects taxpayers to ante up is ridiculous. That would be appropriate if there were no children, or if the children are ill, but “don’t get along” is not an excuse for not doing what’s right.” That’s what I was disagreeing with. I have enormous sympathy for the daughter, Marsha, who was the subject of the post. I’m well aware of the issues with nursing homes, and I’m not saying that’s a good solution. I am in favor of more publicly-funded solutions, though, such as Medicaid-funded programs that provide the senior with care at home so that adult children can remain in the workforce and prepare for their own old age rather than having to stop work early to care for the parent.

Carla, I wasn’t clear about your comment at first. Thank you for clarifying. I am in agreement that we definitely need publicly funded ways to keep people in their homes when it’s possible and when they want to stay there. There are some experimental programs to subsidize assisted living in some areas of the country. I believe these are doing well. We would also be better as a society if we paid for home help more than forcing people without funds to live in nursing homes. Research tells us that most folks do better in their own homes and it would be a cost savings for Medicaid to support that.

The news is indeed bleak on the long term care front. According to the American Association for Long Term Care, prices for long term care policies are up 6-17% from this time last year. Some private insurers are dropping the product. Last fall the Obama administration announced it was scrapping a long term care program created by the new health care law because it was deemed too costly and would not work. Meanwhile, stats show that three in four will need long term care…Who’s going to pay for this????